
<script type="text/javascript" src="<?php echo base_url();?>/application/js/formvalidation.js"></script>
<script type="text/javascript" src="<?php echo base_url();?>/application/js/onsubmitform-addresidentview.js"></script>
<h3><img src="<?php echo base_url(); echo "/application/images/relic/residents.png"; ?>" width="30px" height="30px" align="left" />Resident's Information</h3>
<a id="myAnchor" href=""></a>
<div id="errorMessage"></div>
<input type="hidden" name="residentform_action" value="<?php echo base_url();?>index.php/residentController/addResident/" />
<form name="residentform" method="post" onSubmit="return OnSubmitForm();">
<div id="content">
	
	<h3><a href="#section1">Basic Information</a></h3>
	<div>
		<table class="centeredtable">
			<tr><td width="120px"></td><td width="300px"></td></tr>
			<tr><td>Student Number:</td><td><input type="text" class="longobject" name="student_number"/></td></tr>
			<tr><td></td><td><div id="student_number_warning_box"></div></td></tr>
			<tr><td>First Name:</td><td><input type="text" class="longobject" name="first_name"/></td></tr>
			<tr><td></td><td><div id="first_name_warning_box"></div></td></tr>
			<tr><td>Middle Name:</td><td><input type="text" class="longobject" name="middle_name"/></td></tr>
			<tr><td></td><td><div id="middle_name_warning_box"></div></td></tr>
			<tr><td>Last Name:</td><td><input type="text" class="longobject" name="last_name"/></td></tr>
			<tr><td></td><td><div id="last_name_warning_box"></div></td></tr>
			<tr><td>Gender:</td><td>
				<select name="gender" class="longobject">
					<option>Female</option>
					<option>Male</option>
				</select>
			</td></tr>
			<tr><td>Civil Status:</td><td>
				<select name="civil_status" class="longobject">
					<option selected="selected">Single</option>
					<option>Married</option>
					<option>Divorced</option>
					<option>Separated</option>
					<option>In a Relationship</option>
					<option>It's Complicated</option>
					<option>Not Applicable</option>
				</select>
			</td></tr>
			<tr><td>Birthday:</td><td><input type="text" class="longobject" id="datepicker" name="birthday"/></td></tr>
			<tr><td></td><td><div id="birthday_warning_box"></div></td></tr>
			<tr><td>Religion:</td><td><input type="text" class="longobject" name="religion"/></td></tr>
			<tr><td></td><td><div id="religion_warning_box"></div></td></tr>
		</table>
	</div>
	
	<h3><a href="#section2">College and Contact Information</a></h3>
	<div>
		<table class="centeredtable">
			<tr><td width="120px"></td><td width="300px"></td></tr>
			<tr><td>Course:</td><td><input type="text" class="longobject" name="course"/></td></tr>
			<tr><td></td><td><div id="course_warning_box"></div></td></tr>
			<tr><td>College:</td><td>
				<select name="college">				
					<option selected="selected" value="CA">College of Agriculture (CA)</option>
					<option value="CDC">College of Development Communication (CDC)</option>
					<option value="CEM">College of Economics &amp; Management (CEM)</option>
					<option value="CEAT">College of Engr. &amp; Agro-Industrial Tech. (CEAT)</option>
					<option value="CFNR">College of Forestry &amp; Natural Resources (CFNR)</option>
					<option value="CHE">College of Human Ecology (CHE)</option>
					<option value="CVM">College of Veterinary Medicine (CVM)</option>
					<option value="CA-CAS">CA-CAS Joint Program</option>
					<option value="CAS">College of Arts &amp; Sciences (CAS)</option>
				</select>
			</td></tr>
			<tr><td>Classification:</td><td>
				<select name="classification" class="longobject">
					<option selected="selected">Freshman</option>
					<option>Sophomore</option>
					<option>Junior</option>
					<option>Senior</option>
				</select>
			</td></tr>
			<tr><td>Home Address:</td><td><input type="text" class="longobject" name="home_address"/></td></tr>
			<tr><td></td><td><div id="home_address_warning_box"></div></td></tr>
			<tr><td>Telephone Number:</td><td><input type="text" class="longobject" name="telephone_number"/></td></tr>
			<tr><td></td><td><div id="telephone_number_warning_box"></div></td></tr>
			<tr><td>Email Address:</td><td><input type="text" class="longobject" name="email_address"/></td></tr>
			<tr><td></td><td><div id="email_address_warning_box"></div></td></tr>
			<tr><td>Region:</td><td>
				<select name="region" class="longobject">
					<option selected="selected" value="NCR">National Capital Region (NCR)</option>
					<option value="I">Region 1 - Ilocos Region</option>
					<option value="II">Region 2 - Cagayan Valley</option>
					<option value="III">Region 3 - Central Luzon</option>
					<option value="IVa">Region 4-A - CALABARZON</option>
					<option value="IVb">Region 4-B - MIMAROPA</option>
					<option value="V">Region 5 - Bicol Region</option>
					<option value="VI">Region 6 - Western Visayas</option>
					<option value="VII">Region 7 - Central Visayas</option>
					<option value="VIII">Region 8 - Eastern Visayas</option>
					<option value="IX">Region 9 - Zamboanga Peninsula</option>
					<option value="X">Region 10 - Northern Mindanao</option>
					<option value="XI">Region 11 - Davao Region</option>
					<option value="XII">Region 12 - SOCCSKSARGEN</option>
					<option value="XIII">Region 13 </option>
					<option value="CAR">Cordillera Administrative Region (CAR)</option>
					<option value="CARAGA">CARAGA Region</option>
					<option value="ARMM">Autonomous Region of Muslim Mindanao (ARMM)</option>
				</select>
			</td></tr>
		</table>
	</div>
	
	<h3><a href="#section3">Other Information</a></h3>
	<div>
		<table class="centeredtable">
			<tr><td width="120px"></td><td width="300px"></td></tr>
			<tr><td>Name of Father:</td><td><input type="text" class="longobject" name="name_of_father"/></td></tr>
			<tr><td></td><td><div id="name_of_father_warning_box"></div></td></tr>
			<tr><td>Contact Number:</td><td><input type="text" class="longobject" name="telnumber_of_father"/></td></tr>
			<tr><td></td><td><div id="telnumber_of_father_warning_box"></div></td></tr>
			<tr><td>Name of Mother:</td><td><input type="text" class="longobject" name="name_of_mother"/></td></tr>
			<tr><td></td><td><div id="name_of_mother_warning_box"></div></td></tr>
			<tr><td>Contact Number:</td><td><input type="text" class="longobject" name="telnumber_of_mother"/></td></tr>
			<tr><td></td><td><div id="telnumber_of_mother_warning_box"></div></td></tr>
			<tr><td>Name of Guardian:</td><td><input type="text" class="longobject" name="name_of_guardian"/></td></tr>
			<tr><td></td><td><div id="name_of_guardian_warning_box"></div></td></tr>
			<tr><td>Contact Number:</td><td><input type="text" class="longobject" name="telnumber_of_guardian"/></td></tr>
			<tr><td></td><td><div id="telnumber_of_guardian_warning_box"></div></td></tr>
		</table>	
	</div>
	
</div><!-- End content -->
<br/>
	<input type="reset" value="Reset" class="shortobject"/>
	<input type="submit" value="Add Resident" class="shortobject" onClick="document.pressed=this.value"/>
	<input type="submit" value="Back to Main" class="shortobject" onClick="document.pressed=this.value"/>
</form>
